Randomized controlled trial of an intervention to prevent adherence failure among HIV-infected patients initiating antiretroviral therapy.

OBJECTIVE: Compare the efficacy of a multicomponent social support intervention to standard-of-care counseling on medication adherence among HIV-infected patients initiating antiretroviral therapy. DESIGN: Randomized controlled trial. Generalized estimating equations tested for differences in the percentage of participants achieving 90% adherence. MAIN OUTCOME MEASURES: Pill-taking, electronically monitored over 6 consecutive months; plasma viral load (VL), assessed at 3 and 6 months following initiation of therapy. RESULTS: Of 226 participants who were randomized and began the trial, 87 (38%) were lost to the study by 6 months. The proportion of adherent participants declined steadily over time, with no time by group interaction. Sustained adherence was associated with increased odds of achieving an undetectable VL (OR=1.78; 95% CI=1.01, 3.13). In intention-to-treat analyses, a larger proportion of the intervention group than the control group was adherent (40.15% vs. 27.59%, p=.02) and achieved an undetectable VL p=.04). However, the majority of participants who remained on study experienced some reduction in VL (>or=1-log drop or undetectable), regardless of experimental condition. CONCLUSION: The multicomponent social support intervention significantly improved medication adherence over standard-of-care counseling; evidence for improved virologic outcomes was inconsistent. Early discontinuation of care and treatment may be a greater threat to the health of HIV patients than imperfect medication-taking.     

The valuing process: A study of favorite songs and the inner experience of persons diagnosed with schizophrenia

Since valuing is a process grounded in the organizational tendency of human behavior, the characteristics of a highly valued object should reflect the experience of the individual who selects it. This research compared the favorite songs of fourteen individuals diagnosed with schizophrenia to their inner experience as assessed in a standard interview. Many relationships were revealed between the two, often pertaining to important issues identified in theories of schizophrenia. Results may have therapeutic applications and shed light on processes through which psychological difficulties persist.     

As If Your Life Depended on It: Promoting Cognitive Development to Promote Wellness

In this article the authors discuss key elements of the cognitive-developmental perspective and the need to integrate it as an important component of the wellness model. Each speaks to the personal empowerment of every person to live a rewarding and responsible life. Each also emphasizes the ongoing promotion of growth rather than secondary prevention or remediation.     

Contributions of a supportive work environment to parents' well-being and orientation to work

Examined the joint and unique contributions of informal social support in the workplace and formal, family-responsive benefits and policies provided by employers to the job-related attitudes and personal well-being of employed parents with a young child. Eighty married men, 169 married women, and 72 single women with a preschool child completed a survey concerning social support from co-workers and supervisor, utilization of family-responsive benefits and policies, readiness to leave the employer for additional benefits, job satisfaction, organizational commitment, role strain, and health symptoms. Among the findings: (a) Fathers and mothers expressed equal levels of job satisfaction and organizational commitment, but mothers reported more role strain and health symptoms; (b) nearly 48% of married women's organizational commitment was accounted for by measures of support in the workplace; (c) informal social support at work was significantly more important to men's well-being than that of women; and (d) formal, family-responsive policies appeared more consequential for the prediction of women's role strain, perhaps because of women's greater responsibility for adjusting work life to meet the demands of family roles.     

Hypermnesia occurs in recall but not in recognition

Two experiments investigated the effect of encoding conditions and type of test (recall vs. recognition) on the phenomenon of hypermnesia (improved performance across repeated tests). Subjects in Experiment 1 studied a list of words using either imaginal or semantic elaboration strategies and then received three successive tests. Different groups of subjects received either free recall, four-alternative forced-choice recognition, or yes/no recognition tests. Reliable hypermnesia was found only in the recall conditions, with the recognition conditions showing either no change in performance levels across tests (forced-choice tests) or significant forgetting (yes/no tests). In Experiment 2, subjects studied a list of words, and encoding was manipulated using three orienting tasks. Once again, hypermnesia was found with the recall tests but not with the forced choice recognition tests. Finding hypermnesia in recall but not in recognition indicates that retrieval processes in recall play a major role in producing hypermnesia. Also, the finding that the magnitude of the recall hypermnesias increased with an increase in total cumulative recall levels across study conditions suggests that cumulative recall levels are an important factor in determining the presence or absence of recall hypermnesia.     

Sex-role effects (if any)

Two studies that seem to show conflicting effects of sex role on psychomotor reminiscence and performance are reviewed, and an effort is made to reconcile the discrepant results.     

Locus of control,choice, and satisfaction with an assigned task

P. E. Spector's (1982, Psychological Bulletin, 91, 482–497) hypothesis that under conditions of freedom of choice persons characterized by an internal locus of control will experience greater satisfaction with an undesirable task than persons characterized by an external locus of control is considered in light of distinctions between perceived control and perceived choice. Perceived choice is proposed as an intervening variable implicit in Spector's argument. This reasoning was tested with 46 male and female college student participants in a 2 (Choice) × 2 (Locus of Control) factorial design experiment. An interaction of Choice × Locus of Control on task satisfaction was obtained such that internals tended to be more satisfied when given a choice while externals experienced greater satisfaction when not given a choice. The implications of this result for Spector' hypothesis and for the manner in which undesirable work is assigned are discussed.     

Susceptibility to prosocial and antisocial influence in adolescence following mindfulness training

Mindfulness training programmes have shown to encourage prosocial behaviours and reduce antisocial tendencies in adolescents. However, less is known about whether training affects susceptibility to prosocial and antisocial influence. The current study investigated the effect of mindfulness training (compared with an active control) on self-reported prosocial and antisocial tendencies and susceptibility to prosocial and antisocial influence. 465 adolescents aged 11–16 years were randomly allocated to one of two training programmes. Pre- and post-training, participants completed a social influence task. Self-reported likelihood of engaging in prosocial and antisocial behaviours did not change post-training, and regardless of training group, participants showed a higher propensity for prosocial influence than for antisocial influence. Finally, participants were less influenced by antisocial ratings following both training programmes.